tetano
Editor, Senior Moderator
J Crit Care
. 2020 Sep 25;61:39-44.
doi: 10.1016/j.jcrc.2020.09.021. Online ahead of print.
The clinical spectrum of pulmonary thromboembolism in patients with coronavirus disease-2019 (COVID-19) pneumonia: A European case series
Yasser Sakr[SUP] 1 [/SUP], Manuela Giovini[SUP] 2 [/SUP], Marc Leone[SUP] 3 [/SUP], Giacinto Pizzilli[SUP] 4 [/SUP], Andreas Kortgen[SUP] 5 [/SUP], Michael Bauer[SUP] 5 [/SUP], Tommaso Tonetti[SUP] 4 [/SUP], Gary Duclos[SUP] 3 [/SUP], Laurent Zieleskiewicz[SUP] 3 [/SUP], Samuel Buschbeck[SUP] 5 [/SUP], V Marco Ranieri[SUP] 4 [/SUP], Elio Antonucci[SUP] 2 [/SUP]
Affiliations
Abstract
Purpose: To describe the clinical characteristics and outcomes of coronavirus disease-2019 (COVID-19)-associated pulmonary thromboembolism (PTE).
Materials and methods: A case series of five patients, representing the clinical spectrum of COVID-19 associated PTE. Patients were admitted to four hospitals in Germany, Italy, and France. Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was confirmed using a real-time reverse transcription polymerase chain reaction test.
Results: The onset of PTE varied from 2 to 4 weeks after the occurrence of the initial symptoms of SARS-CoV-2 infection and led to deterioration of the clinical picture in all cases. PTE was the primary reason for hospital admission after a 2-week period of self-isolation at home (1 patient) and hospital readmission after initial uncomplicated hospital discharge (2 patients). Three of the patients had no past history of clinically relevant risk factors for venous thromboembolism (VTE). Severe disease progression was associated with concomitant increases in IL-6, ferritin, and D-Dimer levels. The outcome from PTE was related to the extent of vascular involvement, and associated complications.
Conclusion: PTE is a potential life-threatening complication, which occurs frequently in patients with COVID-19. Intermediate therapeutic dose of anticoagulants and extend thromboprophylaxis are necessary after meticulous risk-benefit assessment.
Keywords: COVID-19; Pulmonary embolism; SARS-CoV-2; Thromboprophylaxis; Venous thromboembolism.
. 2020 Sep 25;61:39-44.
doi: 10.1016/j.jcrc.2020.09.021. Online ahead of print.
The clinical spectrum of pulmonary thromboembolism in patients with coronavirus disease-2019 (COVID-19) pneumonia: A European case series
Yasser Sakr[SUP] 1 [/SUP], Manuela Giovini[SUP] 2 [/SUP], Marc Leone[SUP] 3 [/SUP], Giacinto Pizzilli[SUP] 4 [/SUP], Andreas Kortgen[SUP] 5 [/SUP], Michael Bauer[SUP] 5 [/SUP], Tommaso Tonetti[SUP] 4 [/SUP], Gary Duclos[SUP] 3 [/SUP], Laurent Zieleskiewicz[SUP] 3 [/SUP], Samuel Buschbeck[SUP] 5 [/SUP], V Marco Ranieri[SUP] 4 [/SUP], Elio Antonucci[SUP] 2 [/SUP]
Affiliations
- PMID: 33075608
- PMCID: PMC7518181
- DOI: 10.1016/j.jcrc.2020.09.021
Abstract
Purpose: To describe the clinical characteristics and outcomes of coronavirus disease-2019 (COVID-19)-associated pulmonary thromboembolism (PTE).
Materials and methods: A case series of five patients, representing the clinical spectrum of COVID-19 associated PTE. Patients were admitted to four hospitals in Germany, Italy, and France. Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was confirmed using a real-time reverse transcription polymerase chain reaction test.
Results: The onset of PTE varied from 2 to 4 weeks after the occurrence of the initial symptoms of SARS-CoV-2 infection and led to deterioration of the clinical picture in all cases. PTE was the primary reason for hospital admission after a 2-week period of self-isolation at home (1 patient) and hospital readmission after initial uncomplicated hospital discharge (2 patients). Three of the patients had no past history of clinically relevant risk factors for venous thromboembolism (VTE). Severe disease progression was associated with concomitant increases in IL-6, ferritin, and D-Dimer levels. The outcome from PTE was related to the extent of vascular involvement, and associated complications.
Conclusion: PTE is a potential life-threatening complication, which occurs frequently in patients with COVID-19. Intermediate therapeutic dose of anticoagulants and extend thromboprophylaxis are necessary after meticulous risk-benefit assessment.
Keywords: COVID-19; Pulmonary embolism; SARS-CoV-2; Thromboprophylaxis; Venous thromboembolism.